Drug-Induced Hematologic Disorders
First Things First (assess & treat for the following)
- These side effects can occur in the marrow or systemically, and hematologic effects of drugs can be mediated by one or many factors.
- Dysfunction can range in severity from mild to severe, and the clinical picture is variable.
- Hemolysis is usually not severe, but life-threatening cases do occur, esp. in pts with comorbid conditions.
- Some drug-induced disorders may occur weeks to years after use.
- Suspect cephalosporin- or quinidine-induced hemolytic anemia if acute, severe hemolysis occurs with renal failure.
- Diagnostic tests are not always specific; usually the diagnosis made with history, physical & removal of suspected drug.
- Suspect drug-induced hemolytic anemia if:
- Anemia, fevers, rash, renal failure develop when drug started
- Hemolytic indices are seen:
- Anemia, cytopenias
- Increased LDH
- Decreased haptoglobin
- Increased indirect bilirubin
- Discontinue any new drug that may be responsible for a recent change in pt’s condition.
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